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HomeMy WebLinkAboutBLD2000-00208 PROPANE/PELLET/WOOD STOVE & TANK INSTALLATION PERMIT Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360) 379-4450 FAX (360) 379-4451 (800)831-2678 PERMIT #: BLD00-00208 Received Date 4/3/2000 SITE ADDRESS: 530 CITY LAKE RD Issue Date 4/4/2000 PORT TOWNSEND, 98368 Expiration Date 4/4/2001 APPLICANT: CITY OF PORT TOWNSEND PHONE: ENGINEERING DIVISION 181 QUINCY ST STE 201 PORT TOWNSEND WA 98368 SUBDIVISION: TAX 26 Block: Lot: PARCEL NUMBER: 901194001 Section: 19 Township: 29N Range: 01W CONTRACTOR: SUBURBAN PROPANE PHONE: 385-5096 P 0 BOX 989 PORT TOWNSEND WA 98368 Contractor's License SUBURPL044DA Expires 03/01/2001 OWNER, if different: PROJECT DESCRIPTION PROPANE TANK INSTALLATION THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 04/04/2001. REQUIRED INSPECTIONS: [1]`' Tank/Line/Appliance: [ FinalApproval: lek 11/b © 60 BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. Inspector's Phone Hours 8:00 a.m. - 9:00 a.m. SPECIAL CONDITIONS MAY APPLY - SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY p r , BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00208 Received Date: 4/3/2000 SITE ADDRESS: 530 CITY LAKE RD PORT TOWNSEND, 98368 APPLICANT: CITY OF PORT TOWNSEND PHONE: ENGINEERING DIVISION 181 QUINCY ST STE 201 PORT TOWNSEND WA 98368 SUBDIVISION: TAX 26 Block: Lot: PARCEL NUMBER: 901194001 Section: 19 Township: 29 N Range: 01 W CONTRACTOR: SUBURBAN PROPANE PHONE: 385-5096 P 0 BOX 989 PORT TOWNSEND WA 98368 Contractor's License SUBURPL044DA Expires 03/01/2001 ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: PROPANE TANK INSTALLATION TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: STORMWATER: YES NO AREA BEDROOMS: BATHROOMS: Wetland Erosion Exist: Exist: Seismic Streams Prop: Prop: Flooding Landslide Total: Total: F&W Plat Conditions Shoreline Aquifer Routing Date: Forest: Commercial Rural Proximity Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 MAM 04/03/00 27119 Total: $48.00 i:\F_BLD_App_Bld.rpt 10/29/99 JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE X PROPANE TANK PELLET STOVE OTHER SITE ADDRESS: 911#/ROAD NAME ZIP 9DIGITPARCELIDNUMBER '1Q1 ' gUI11 " DO Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT s^lQ,i•'< 1711, (G�tL PHONE LYG - -C‘‘ . MAILING ADDRESS � �C� (E l�y �vr^ �GV /1. `GQ ZIP /a j C i 7 PROPERTY OWNER Q r /GLv,�S�c C'( PHONE MAILING ADDRESS ZIP CONTRACTOR Si-) 5(4 4H foeco,L,y I� PHONE MAILING ADDRESS ZIP STATE LICENSE it EXP. DATE FEDERAL I.D. # By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save, indemnify and hold harmless Jefferson County against all liabilities,judgments, court costs, reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and it's employees, representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. APPLICANT SIGNATURE DATE / / FOR OFFICE USE ONLY BASE FEE RECEIPT it CASH/CK TOTAL DATE H:\HOME\PLN CNTR\FORMS\I NSTALL.DOC 10/99